Thieme et al (2016) describe the challenges and lessons learned when adopting an experience-centred design approach to deploy technologies with a group of women experiencing significant mental health problems in a medium secure hospital unit. The project was 3 ½ years long and involved designing a technology for and with a group of women with learning difficulties and diagnoses of Borderline Personality Disorder (BPD).
In collaboration with mental healthcare professionals in the hospital, the research team developed the concept of Spheres of Wellbeing: a) the Mindfulness Sphere which is a ‘digital crystal ball’ that reflects a person’s heart beat to assist in the practice of mindfulness; b) the Calming Sphere – a non digital bead bracelet that serves as a distraction technique for when an individual feels anxious; and c) the Identity Sphere that plays visual content that is configured to be meaningful and personal. These concepts were deployed within the hospital over a 15 week evaluation period where qualitative interviews and interaction data were captured.
The challenges that arose from the Spheres of Wellbeing project were characterised by the difficulties of balancing the needs and priorities of the women experiencing the care, those delivering the care, and the research team. The constraints of existing work practices in the hospital, existing ward culture, and juxtaposition of the philosophy of care and the exploratory nature of the project, all proved to be challenges illustrated by the authors. I was overwhelmed by the parallels to be drawn with my own research in the context of individuals affected by self-harm. I asked mental health professionals and charity workers to critique and unpick how and if digital tools conceptualised at a hackathon could enrich the lives of those affected by self-harm. I suppose I naively hoped to gain some sort of validation that the tools that were favoured by those with lived experience could indeed take a trajectory in which they could be integrated into some form of service provision. What I did encounter was a lot of reluctance and resistance to say one way or the other if each particular tool could be adopted by statutory services. Although the MHPs agreed that the concepts had the potential to enrich the lives of those experiencing self-harm, they were concerned that their services’ philosophy of care would not permit them to be integrated into service provision.
The challenges in Thieme’s work pertaining to primary care responsibilities, existing ward and hospital culture, conflicting work responsibilities, and lack of service integration are all worth bearing in mind for my own future work. When viewed in conjunction with the challenges in my own work, particularly relating to stakeholder conflicts, a broader question about whether to ‘design new healthcare practices around the technology’ is raised.